温针灸联合生物反馈电刺激治疗对阴道顺产高龄产妇卵巢功能及产后生活质量的影响

Effects of warm acupuncture combined with biofeedback electrical stimulation on ovarian function and postpartum quality of life in advanced-age women after vaginal birth

关键词:  温针灸  生物反馈电刺激  阴道顺产  高龄产妇  卵巢功能  生活质量

Key words:  warm acupuncture  biofeedback electrical stimulation  vaginal delivery  advanced-age women after vaginal birth  ovarian function  quality of life

摘要:

目的 分析温针灸联合生物反馈电刺激治疗对阴道顺产高龄产妇卵巢功能及产后生活质量的影响。方法 前瞻性连续纳入2019年6月—2023年6月203例于湖南中医药大学第二附属医院康复治疗的阴道顺产高龄产妇，根据纳入排除标准最终纳入148例阴道顺产高龄产妇，采用电脑随机分配法将产妇分为对照组（生物反馈电刺激治疗，74例）与研究组（温针灸联合生物反馈电刺激治疗，74例），对比两组治疗前后卵巢功能指标[促卵泡生成素（FSH）、促黄体生成素（LH）、抗缪勒管激素（AMH）、窦卵泡计数（AFCs）]的变化及卵巢血流动力学指标[卵巢阻力指数（RI）、搏动指数（PI）]变化，并记录其子宫体积与子宫内膜厚度差异、月经复潮时间及月经持续时间，随后对产妇展开6个月的跟踪随访，无中途退出产妇，并对比治疗前后36项生活质量评分量表（SF-36）变化。结果 治疗后，研究组FSH、FSH/LH较对照组下降，AMH、AFCs高于对照组（P < 0.05）；治疗后，研究组卵巢血流动力学指标（RI、PI）显著低于对照组（P < 0.05）；治疗后，两组子宫体积与子宫内膜厚度较治疗前均显著升高（P < 0.05），但两组组间比较差异无统计学意义（P > 0.05）；研究组与对照组比较，月经复潮时间短、月经持续时间长（P < 0.05）。随访6个月后，研究组产妇SF-36显著高于对照组（P < 0.05）。结论 温针灸联合生物反馈电刺激治疗能显著改善阴道顺产高龄产妇卵巢功能及产后生活质量，为临床高龄产妇的产后修复提供保障，可广泛适用于临床。

Abstract:

Objective To analyze the effect of warm acupuncture combined with biofeedback electrical stimulation on ovarian function and postpartum quality of life in advanced-age women after vaginal birth.Methods The 203 advanced-age women after vaginal birth who received rehabilitation treatment at The Second Affiliated Hospital of Hunan University of Chinese Medicine from June 2019 to June 2023 were prospectively and continuously included. The 148 advanced-age women were finally included according to the inclusion and exclusion criteria. The puerpera were randomly divided into the control group(74 cases treated with biofeedback electrical stimulation) and the study group(74 cases treated with warm acupuncture combined with biofeedback electrical stimulation). The changes of ovarian function indexes [follicle stimulating hormone(FSH), FSH/luteinizing hormone(LH), anti-Mullerian hormone(AMH) and antral follicle count(AFCs)] and ovarian hemodynamic indexes [ovarian resistance index(RI), pulsatility index(PI)] before and after treatment were compared between the two groups. The differences of uterine volume and endometrial thickness, the resumption time of menstruation and the duration of menstruation were recorded. Then the puerpera were followed up for 6 months, and no puerpera dropped out. The changes of short form 36-item health survey(SF-36) before and after treatment were compared.Results After treatment, FSH and FSH/LH in the study group were lower than those in the control group, and AMH and AFCs were higher than those in the control group(P < 0.05). After treatment, ovarian hemodynamic indexes(RI and PI) in the study group were significantly lower than those in the control group(P < 0.05). After treatment, the uterine volume and endometrial thickness of the two groups were significantly higher than those before treatment(P < 0.05), but there was no significant difference between the two groups(P > 0.05). Compared with the control group, the recovery time of menstruation was shorter and the duration of menstruation was longer in the study group(P < 0.05). After 6 months of follow-up, the SF-36 of the study group was significantly higher than that of the control group(P < 0.05).Conclusion Warm acupuncture combined with biofeedback electrical stimulation can significantly improve the ovarian function and postpartum quality of life of advanced-age women after vaginal birth, and provide a guarantee for postpartum repair of elderly parturient, which can be widely used in clinical practice.